NPIMap

Organization Active NPI

Directcare Physician Services, S.C.

  • Family Medicine Physician
  • Rockford, IL
National Provider Identifier
1780934166
Registry record updated Oct 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DIRECTCARE PHYSICIAN SERVICES, S.C.
Practice address
7117 Crimson Ridge Dr
Suite 3
Rockford, IL 61107-6213
Phone
(815) 633-8099
Fax
(630) 658-0543
NPI assigned
Sep 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph J Eckburg, MD
Title
President
Phone
(815) 751-6316

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7117 Crimson Ridge Dr
Suite 3
Rockford, IL 61107-6213

Mailing address

7117 Crimson Ridge Dr
Suite 3
Rockford, IL 61107-6213
Phone (815) 316-8700

National Provider Directory

National Provider Directory

Locations

815 10TH St
Oregon Living and Re
Oregon, IL 61061
Phone (815) 732-7994

7117 Crimson Ridge Dr
Rockford, IL 61107

7117 Crimson Ridge Dr
Ste 3
Rockford, IL 61107
Phone (815) 316-8700

3650 N Alpine Rd
Rockford, IL 61114
Phone (815) 877-7408

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1780934166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7117 CRIMSON RIDGE DR",
            "address_2": "SUITE 3",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076213",
            "telephone_number": "815-316-8700",
            "fax_number": "310-356-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7117 CRIMSON RIDGE DR",
            "address_2": "SUITE 3",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076213",
            "telephone_number": "815-633-8099",
            "fax_number": "630-658-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECTCARE PHYSICIAN SERVICES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-13",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "ECKBURG",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-751-6316",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.